Inflammatory markers in the emergency department and PTSD symptoms in the AURORA Study: A longitudinal cohort study.
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Nishimi Kristen, Linnstaedt Sarah D, Neylan Thomas C, McKibben Lauren A, Albertorio-Sáez Liz Marie, Zhao Ying, House Stacey L, Beaudoin Francesca L, An Xinming, Stevens Jennifer S, Clifford Gari D, Jovanovic Tanja, Germine Laura T, Rauch Scott L, Haran John P, Storrow Alan B, Musey Paul I, Hendry Phyllis L, Sheikh Sophia, Punches Brittany E, Swor Robert A, Pascual Jose L, Seamon Mark J, Datner Elizabeth M, Pearson Claire, Peak David A, Merchant Roland C, Domeier Robert M, Rathlev Niels K, O'Neil Brian J, Sergot Paulina, Sanchez Leon D, Bruce Steven E, Harte Steven E, Kessler Ronald C, Koenen Karestan C, Ressler Kerry J, McLean Samuel A, O'Donovan Aoife
Аннотация
METHODS: Our sample included 742 AURORA participants, a longitudinal cohort of patients in 29 EDs across the United States after a traumatic stressor, followed up to 6 months. Plasma cytokines were assessed from a study blood draw in the ED: an inflammatory index (standardized sum of generally pro-inflammatory markers interleukin [IL]-6, IL-8, tumor necrosis factor alpha [TNF-α], interferon gamma [IFN-γ]), and generally anti-inflammatory IL-10. PTSD symptoms were self-reported at 2 weeks, 8 weeks, 3 months, and 6 months post-ED. Covariate-adjusted repeated-measures regressions estimated associations between inflammation and PTSD symptoms, overall and sex-stratified.
RESULTS: Among 742 participants (age m = 40.0 [13.7]; 479 [64.6%] female), PTSD symptoms were elevated then modestly decreased over follow-up. Higher ED inflammation was associated with higher PTSD symptoms across follow-up (standardized symptoms β = 0.05, 95% CI: 0.01-0.09), adjusted for potential confounders. Higher pro-inflammatory index levels and IL-6, IL-8, and TNF-α were associated with higher PTSD symptoms in males only, while higher IL-10 was associated with higher PTSD symptoms in females only.
CONCLUSIONS: Pro-inflammatory levels shortly after traumatic stress are associated with heightened PTSD symptoms, particularly among males. Inflammatory markers may prove useful additions to prediction models for PTSD following trauma, with attention to sex differences.